Predicting and preventing acute kidney injury after cardiac surgery.
OBJECTIVE
Acute kidney injury (AKI) after cardiac surgery is associated with significant morbidity and mortality. Despite the proliferation of predictive clinical scoring models of renal risk after cardiac surgery, limitations in preventing AKI through the use of pharmacological agents remain. Here we review the evolution of predictive models of renal risk after cardiac surgery, and highlight the important gains made in preventing its occurrence.


RESULTS
Simple risk indices predicting AKI after cardiac surgery have been developed and can now be readily applied clinically. However, studies focusing on preventing AKI after surgery have yet to demonstrate any consistent renoprotective effect.


CONCLUSIONS
Clinical scoring systems predicting AKI risk after cardiac surgery are available and should be employed in the preoperative assessment. Elucidation of beneficial preventive strategies of AKI after cardiac surgery requires ongoing research.
Harel
Ziv
Z
Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Chan
Christopher T
CT
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D045283:Natriuretic Agents / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012079:Renal Circulation / Q000187:drug effects; D018570:Risk Assessment; D012307:Risk Factors
D000893:Anti-Inflammatory Agents; D002317:Cardiovascular Agents; D045283:Natriuretic Agents